Current Analysis of Hangings That Deviates From Recently Published Studies

The constellation of injuries observed in hangings is a subject receiving frequent review in forensic pathology literature. Whereas recent studies have reported high concordance between hangings and internal findings such as strap muscle hemorrhages and hyoid bone and thyroid cartilage fractures, a 2-part study examining autopsied suicidal hangings over a 9-year period at the Wayne County Medical Examiner's Office produced markedly differing results. Retrospectively and prospectively, external and internal autopsy observations were correlated with factors such as age, sex, body height, body mass index, ligature, and height of suspension. In keeping with well-established forensic textbooks, nearly all cases displayed ligature marks and there was strong association between body position and the presence of petechiae. Diverging from contemporary articles, there was a distinctive paucity of internal injuries in both retrospective and prospective portions. Addressing concerns of confirmation bias, assessments confirmed the consistency in identifying and documenting injuries by the pathologists both retrospectively and prospectively.